Evil, Terrorism & Psychiatry

9781108467766

Terrorism has dominated the domestic and international landscape since 9/11. Determining what drives people to commit acts of terrorism is no easy task. The important new book fills a gap in the psychology and psychiatry literature by examining the relationship between evil and mental illness, and in particular amongst terrorists. How can evil, a characteristic of human nature, become extreme, intent on destruction and lead to acts of terrorism? Featuring contributions from leading experts in this field, Evil, Terrorism and Psychiatry explores whether there are specific personality traits, psychological characteristics or psychopathological conditions that may favour a lack of control of violence in terrorists. It also offers possible novel prevention strategies to help understand and prevent these acts in future. Featuring articles from a special issue of CNS Spectrums, this book also includes brand new chapters found exclusively in this book.

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Foreword

No one is willingly evil, but one can become evil for a bad disposition in his body and for a training without a true education; this is hideous for everyone and happens against his will (Plato, Timaeus, 86e). This citation alone would suffice to show how understanding behavior has fascinated humans since ancient times.

Over the last few decades, the development of behavioral neuroscience has fostered the study of the biological correlates that subtend the mental processes involved in moral choices and social behavior. Novel brain-imaging methodologies, including positron emission tomography (PET), magnetic resonance imaging (MRI) and high-resolution electro-encephalography (EEG-mapping), have allowed scientists to adventure into the marvellous morphological and functional architecture of the human brain in an unprecedented manner. Furthermore, techniques such as transcranial magnetic stimulation (TMS) have made it possible to probe the brain by inducing temporary functional perturbations in selected cortical regions.

At the same time, the decoding of the human genome has paved the way to the study of the role of different genetic alleles in shaping personality, behavior, and vulnerability to mental disorders, as well as to understanding individual variability in response to pharmacological and even to psychotherapeutic interventions.

Neuroscience has proven to be a powerful tool to explore issues across multiple disciplines, ranging from philosophy to ethics, from economics to law, from genetics to psychiatry itself. The dialogue between social and experimental sciences has given renovated vigor to ancient questions. For instance, whether psychopathic criminals should be considered bad or mad is no longer a matter of abstract speculation, but rather has become the object of scientific investigations in which structural and functional measures in brain regions devoted to emotional processing and behavioral control are combined with evaluation of genetic factors that may affect vulnerability to aversive environmental factors during childhood. This nature by nurture interaction in turn may result in increased risk of expressing antisocial and impulsive behavior during adulthood. Recently, novel neuroscience advancements have entered the 2 forensic debate and the law.

In view of evidence coming from neuroscience, the question of the extent to which individuals are free and responsible for their actions has taken on renewed vigor. The issue reconnects to the medieval debate in the ethical and philosophical realm on free will versus determinism, a debate whose echo resonates in the courtroom. The capability to distinguish good from bad and to decide to act in one way or another is the foundation of the criminal justice system. Indeed, on such a foundation, retributive jurisprudence, typical of all modern societies, bases culpability and imputability.

In this perspective, Evil, Terrorism & Psychiatry offers an original and multidisciplinary approach to the understanding of ideological terrorism. What can neuroscience tell us about the mind—or rather, the brain—of suicide bombers? Which psychopathological factors may play a role? To what extent is religious fanaticism just a matter of molecules in the brain? Can neuroscience, psychiatry, and social sciences by working together develop effective strategies to prevent terrorism sinking deep roots within society?

Readers will find themselves viewing this issue from a new angle, no doubt from a much wider perspective than we have become accustomed to hear in the evening news.

Pietro Pietrini

Psychiatrist and neuroscientist, Director of IMT School for Advanced Studies in Lucca, Italy, and Head of MoMiLab, Molecular Mind Laboratory, at IMT School

Medical Disclaimer

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Information on this title: www.cambridge.org/9781108467766

DOI: 10.1017/9781108569095

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2019

Printed in the United Kingdom by TJ International Ltd. Padstow Cornwall

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Library of Congress Cataloging-in-Publication Data

Names: Marazziti, Donatella, editor. | Stahl, Stephen M., 1951– editor.

Title: Evil, terrorism & psychiatry / edited by Donatella Marazziti, Stephen M. Stahl.

Description: Cambridge, United Kingdom ; New York, NY : Cambridge University Press, 2019. | Includes bibliographical references and index.

Identifiers: LCCN 2018043274 | ISBN 9781108467766 (pbk.)

Subjects: | MESH: Terrorism – psychology | Suicide – psychology | Violence – psychology

Classification: LCC RC454.4 | NLM WM 172.5 | DDC 616.89–dc23

LC record available at https://lccn.loc.gov/2018043274

ISBN 978-1-108-46776-6 Paperback

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Chapter 1	Chapter 8
To Die to Kill: Suicide as a Weapon. Some Historical Antecedents of Suicide Terrorism Stefano Salvatori and Donatella Marazziti	Brain Alterations Potentially Associated with Aggression and Terrorism Bernhard Bogerts , Maria Schöne , and Stephanie Breitschuh
Chapter 2	Chapter 9
The Philosophy of Hate and Anger Claudio Bonito and Guido Traversa	Political Terrorism and Affective Polarization in “Black” and “Red” Terrorists in Italy During the Years 1968–1988 Matteo Pacini and Icro Maremmani
Chapter 3	Chapter 10
Identity, Alienation, and Violent Radicalization Antonio Ventriglio and Dinesh Bhugra	Conditions of Life and Death of Psychiatric Patients in France During World War II: Euthanasia or Collateral Casualties? Patrick Lemoine and Stephen M. Stahl
Chapter 4	Chapter 11
The Mind of Suicide Terrorists Donatella Marazziti , Antonello Veltri , and Armando Piccinni	Neuropsychiatric Characteristics of Antiterrorist Operation Combatants in the Donbass (Ukraine) Konstantin N. Loganovsky , Natalia A. Zdanevich , Marina V. Gresko , Donatella Marazziti , and Tatiana K. Loganovskaja
Chapter 5	Chapter 12
Psychopathology of Terrorists Armando Piccinni , Donatella Marazziti , and Antonello Veltri	The International Scenario of Terrorism Donato Marzano
Chapter 6	Chapter 13
Why is Terrorism a Man’s Business? Anne Maria Möller-Leimkühler	Identification and Prevention of Radicalization. Practice and Experiences with a Multidisciplinary Working Model Dorte Sestoft
Chapter 7	Chapter 14
Religion, Violence, and the Brain: a Neuroethical Perspective Alberto Carrara	How to Fight Terrorism? Political and Strategic Aspects Erich Vad

List of Contributors

Index

acculturation

and alienation/non-belonging

–

in Cuban American adolescents

–

adolescent males

acculturation and deviant behavior

–

susceptibility to radicalization

–

Aesop’s fable example

Afghanistan invasion by Soviet Union, results of

–

aggression see also violence

cortical regions controlling

by “normal” people

Al Qaeda

origins of

–

terrorist groups without direct link to

alienation

–

as a result of poor acculturation

–

protective and contributive factors

social isolation leading to

–

summary

amygdala, criminal psychopaths’ brains

reduced functional connectivity

structural impairment in

anger, philosophical perspective

–

anomie, Durkheim

–

antiterrorism operation (ATO) combatants in Donbass (Ukraine), mental health study

–

discussion and conclusions

–

guidelines for mental healthcare

results

–

subjects and methods

–

Asia, historical examples

–

the Assassins, fundamentalist Muslim sect

–

Berardi, Francesco, Red Brigade member

–

bipolar-related states, link to political terrorism

–

,

–

Blacks (Neofascists) versus Reds (Communists), political terrorists in Italy

–

brain, good versus evil

–

brain imaging studies in violent individuals

conclusions

–

functional imaging

–

structural imaging

–

Breivik, Anders Behring

causes of terrorism

fighting underlying

–

group violence

–

cingulate cortex

functional deficits in violent offenders

structural abnormalities linked to psychopathy and violence

communist ideology, failure of

community-level support for countering terrorism

–

cooperation

between police, social services, and psychiatry (PSP), Denmark

–

in fight against terrorism

–

counterterrorism measures

–

action manual for Western societies

analyzing root causes

delegitimizing terrorism

–

learning from defeats

–

media and social networks

–

multilevel cooperation

–

overview of general situation

resilience versus pacifism

–

summary

–

using sound judgment and patience

–

cowardice of Western world

–

cultural identity and acculturation

–

culture conflict

alienation of third generation

–

link to deviance in adolescents

–

violent radicalization arising from

–

Curcio, Renato, Red Brigade

Daesh (Islamic State) see ISIL/ISIS

death and life, terrorist approach to

defeats in fighting terrorism, learning from

–

Denmark, identification and prevention of radicalization

–

deviance in adolescents, acculturation study

–

DNA profiling

–

Donbass war, Ukraine

features and scope of

Durkheim, Émile

anomie

–

origins of religions

East Germany, economic restructuring, effect on young men

economic stagnation, youth bulges and terrorism

–

education, youth bulges and terrorism risk

–

emotion

and reason, imbalance between

suppression of in the military

empathy, cortical regions associated with

frontal lobe

insula

temporal lobe

–

ethno-cultural continuity

eugenics, psychiatric patients during World War II

–

euthanasia, psychiatric patients during World War II

–

,

–

evil brain, neurobiological perspective

–

evil leaders, manipulating vulnerable brains

–

existentialism

–

,

extremism/extremists see Islamist extremism

family factors, mitigating deviance in immigrant adolescents

–

fanatics

Fenzi, Enrico, former Red Brigade member

,

on “proletarian trials”

–

frontal lobe abnormalities

functional imaging studies

structural imaging findings

–

genetic factors

–

good versus evil brain, neurobiological perspective

–

group acculturation

group violence

neuronal generators of

psychological and sociological theories

–

Hassan-i-Sabbah (1034–1124), founder of Assassins order

–

hate/hatred

of Daesh terrorists

philosophy of

–

providing a strong bond among allies

of Western societies by terrorism

hedonistic component of terrorist attacks

heroes/heroism

–

ISIL strategy targeted at adolescent males

hippocampal formation, structural abnormalities in violent individuals

historical antecedents of terrorism

–

homicide

–

honor and masculinity, Islamic culture

–

human body, used as a weapon

humanity, lack of in suicide terrorists

–

humiliation as motivating force

–

hypermasculinity

hypomanic states in revolutionary leaders

–

identity

acculturation and

–

cultural identity of the third generation

group/collective

–

indoctrination by Islamist ideology

underaged boys in refugee camps

Info-houses, Denmark

–

insula

activation increased in psychopathic inmates

reduced volume in violent offenders

intergroup conflict

international scenario of terrorism

–

internet see social media

ISIL/ISIS

increased terrorist activity in Europe

previous criminal record or recruits

–

targeting of adolescent males

Islamic culture, honor, and masculinity

–

Islamist extremism

based on archaic masculinity

–

hypermasculinity notion

–

young men’s susceptibility

–

Italy see political terrorism in Italy (1968–1988)

journalists, dangers of becoming accomplices of terrorism

–

Kamikaze pilots, Japan

–

Lazagna, Giovanbattista

life and death, terrorist approach to

limbic brain areas of violent individuals

functional deficits

structural abnormalities

–

lone-wolf terrorism

characteristics of

–

network of supporters

love towards humanity, terrorist ideal

Malabar Muslims, India

–

male alliances and group violence

–

male identity/manhood, precariousness of

male violence, neurobiological predispositions for

–

martyrdom/martyrs

Islamist terrorism

–

Muslims of Malabar

suicide terrorists’ lust for

masculinity and violence

–

media

role of enhancing terrorism

–

TV communication, spectator perception

–

Meinhof, Ulrike, brain damage

mental illness and terrorism

conclusions and perspectives

no evidence of link between

–

personality disorders

–

radicalization concerns

–

and violent behavior

,

–

migrants, stigmatization of

–

militarized masculinity

the Moors

–

moral enhancement

neuroethics

–

moral enhancement

–

neuroS/T developments

–

Nietzsche, Friedrich

nihilist theories

non-belonging, sense of

–

turning into subgroup membership

normlessness

–

and anomie

–

optimism, irrational

–

the “other” concept

–

pacifism of Western world

–

patience in fight against terrorism

–

Peci, Roberto, “proletarian trial” and killing of

–

peer influence, terrorist group membership

personality disorders of terrorists

–

personality profiles, ATO combatants

,

PET (Security and Intelligence Service), Denmark

–

dealing with radicalization concerns

training courses for professionals

–

use of PSP cooperation, case studies

–

philosophy of hate and anger

–

perception of terrorism via TV images

–

political killers, the Assassins

–

political terrorism in Italy (1968–1988)

–

communists and neofascists

–

homicide and suicide

–

hypomanic states, revolutionary leaders

–

revolutionary gnosis

–

sociological theories

–

summary remarks

–

posttraumatic stress disorder (PTSD), war combatants

,

progressive deprivation, socioeconomic process

–

propaganda

,

prosociality

religion promoting

–

of some terrorists

PSP (police, social services, psychiatry cooperation), Denmark

–

radicalization awareness, dealing with

role in prevention of radicalization

–

training courses

–

psychiatric patients in France during World War II

–

context

eugenics question

–

euthanasia policy

–

Germany’s starvation program

–

manslaughter verdict by the allies

–

post-war years

psychological theories of terrorism

–

psychopathology of terrorists

–

psychopaths

frontal lobe deficits

limbic areas

not recruited by terrorist groups

–

purposelessness

–

radicalization

adolescent males’ susceptibility to

–

anomie and

–

identification and prevention of

–

Islamist ideology a predominant factor

mental health issue

–

prevention programs

–

of returnees

and social integration

–

rationality of terrorists

Red Army Faction (RAF), Germany

,

Red Brigades (RBs) see political terrorism in Italy (1968–1988)

religion/religiosity

association with violence, hate, and rage

–

controversies over

–

and development of human beings

effect on susceptible individuals

–

leading to extremism

manipulation of by evil leaders

–

neuro-anthropological framework

–

neurobiological perspective on good versus evil brain

neuroethics and moral enhancement

–

and prosociality

–

and shaping of a good brain

–

religious fundamentalism/extremism

–

threatened by Western ideologies

–

and violent radicalization

–

resilience versus pacifism, fight against terrorism

–

revolutionary gnosis

–

right-wing extremists

hypermasculinity of

–

notion of archaic masculinity being threatened

and violent offenses, Germany

Rosso, Roberto, Prima Linea leader

Samson, Biblical example

Sartre, Jean-Paul

scapegoating of the mentally ill

security authorities, competition with terrorists

–

Security and Intelligence Service, Denmark see PET

smartphones, using proactively to combat terrorism

social/collective identity

–

social integration and radicalization

–

social isolation

leading to alienation

–

lone-actor terrorists

and radicalization

social media

as instrument of counterterrorism

terrorists’ use of as a weapon

–

sociological theories of terrorism

–

sound judgment needed in fight against terrorism

–

Soviet Union invasion of Afghanistan (1979), terrorist groups arising from

–

spectator perspective, television communication

–

starvation of psychiatric patients during World War II

–

eugenics question

–

judgment of involuntary manslaughter by the Allies

–

suicide

Durkheim’s anomic

–

of terrorists

–

suicide as a weapon

Aesop’s fable example

the Assassins

–

Kamikaze pilots, Japan

–

the past two centuries

–

Samson, Biblical example

South East Asia

–

zealots

suicide terrorists

–

explanations/theories for behavior of

–

history of South East Asia

–

Kamikaze pilots, Japan

–

profile of

–

psychological features

–

summary remarks

–

survival instinct, reversal of in terrorists

television see also media

images of terrorism and spectator perception

–

temporal lobe

,

–

temporal pole, structural abnormalities

–

terrorism see also counterterrorism measures

definitions

different typologies of

ideology of

–

international scenario

–

key aspects

–

male phenomenon

“otherness” justifying

possible neurobiological basis

recent history

–

research difficulties

–

theories of

–

terrorists see also suicide terrorists

neurobiological predisposition

–

personality of

–

profile of

–

psychopathology of

–

suicide in

–

third generation, alienation of

–

Tuti, Mario, fascist militant

Ukraine, Donbass war see Donbass war, Ukraine

violence

and masculinity

–

neuronal correlates

–

of right-wing extremists, Germany

violent individuals

brain imaging studies

–

pattern of brain dysfunctions

–

vulnerability to deviance, family conflict creating

Wagner, Ernst, brain lesion

–

war in Donbass, Ukraine

–

discussion and guidelines

–

PTSD study of ATO combatants

–

war, waging against terrorism, failure of

warrior, symbol of masculinity

–

Whitman, Charles, brain abnormality

youth bulges and extremism, Germany

–

zealots

Contributors

Dinesh Bhugra
Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

Bernhard Bogerts
Salus-Institut, Magdeburg, Germany

Claudio Bonito
Università Europea di Roma, Rome, Italy

Stephanie Breitschuh
Salus-Institut, Magdeburg, Germany

Alberto Carrara
Università Europea di Roma, Rome, Italy

Marina V. Gresko
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

Patrick Lemoine
Department of Psychiatry, Clinique Lyon Lumière, Lyon, France

Tatiana K. Loganovskaja
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

Konstantin N. Loganovsky
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

Donatella Marazziti
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, and Fondazione BRF Onlus – Institute for Research in Psychiatry and Neuroscience, Lucca, Italy

Icro Maremmani
G. De Lisio Institute of Behavioural Sciences, and Santa Chiara University Hospital, Department of Specialty Medicine, University of Pisa, Pisa, Italy

Donato Marzano
Italian Navy, Italian Fleet, Rome, Italy

Anne Maria Möller-Leimkühler
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany

Matteo Pacini
G. De Lisio Institute of Behavioural Sciences, Pisa, Italy

Armando Piccinni
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa and Fondazione BRF Onlus – Institute for research in psychiatry and neuroscience, Lucca, Italy

Stefano Salvatori
Departimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Italy

Maria Schöne
Salus-Institut, Magdeburg, Germany

Dorte Sestoft
Ministry of Justice, Clinic of Forensic Psychiatry, Blegdamsvej, Copenhagen, Denmark

Stephen M. Stahl
Department of Psychiatry, University of California at San Diego, San Diego, CA, USA

Guido Traversa
Università Europea di Roma, Rome, Italy

Erich Vad
Department of International Relations, Geschwister-Scholl-Institute for Political Sciences, Ludwig–Maximilians–University of Munich, Munich, Germany

Antonello Veltri
Fondazione BRF Onlus – Institute for research in psychiatry and neuroscience, and Dipartimento della Salute Mentale e Dipendenze, Azienda USL Toscana Nord Ovest, Pisa, Italy

Antonio Ventriglio
Department of Mental Health, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy

Natalia A. Zdanevich
Department of Radiation Psychoneurology, National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

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Conditions of Life and Death of Psychiatric Patients in France During World War II: Euthanasia or Collateral Casualties?

Introduction
The Context
Times of Crisis
The Post-War Years
A Parallel Between France and Germany?
The Stands Taken by the Allies
The Question of Eugenics
Disclosures
References

Introduction

Euthanasia of tens of thousands of German psychiatric patients (as many as 200,000) by the Nazis in the T4 and other related programs is now well known.^1,² It is also widely known that more than 48,000 French psychiatric patients died of hunger, exposure, indifference, and oblivion during the early 1940s while France was under Nazi control and while gassing, cremation, and starvation of children with disabilities was occurring inside Germany.^3,⁴ In 1936, before the start of World War II and the Nazi occupation of France, Alexis Carrel, an American Nobel Prize Winner of French descent, published Man: The Unknown,⁵ in which the horror of psychiatric eugenics—with mass involuntary sterilization of psychiatric patients—was made plain for all to see. He would go on to become one of the main intellectual forces in the Vichy government. However, at the same time his book was published, and when the world had already halted involuntary sterilization of psychiatric patients, Nazi psychiatrists moved from sterilization to euthanasia of disabled patients, and tens of thousands made their way to gas chambers or were killed by involuntary starvation or barbiturate overdose as the notorious T4 operation and its successors got under way in Germany.^1,²

Was psychiatric euthanasia by starvation occurring simultaneously in Nazi-occupied France? The figures speak for themselves: 48,588 additional deaths in psychiatric hospitals occurred between 1940 and 1944. In order to have a better understanding of these events, it is helpful to look into one of these hospitals, the Hôpital du Vinatier, a psychiatric facility in Lyon, the country’s second largest city, in the center of France, and where the principal author of the present article (PL) spent many years as a practicing psychiatrist. The present manuscript will refer to original materials referenced and reproduced in an account written by the principal author based on the real history of people who lived at Hôpital du Vinatier in Lyon-Bron during World War II.⁶ Dr. Lemoine has also researched the hospital files at Vinatier and interviewed survivors involved with the hospital during that era. In addition, the book contains several facsimiles and documents (many in French and others in English or German), including: an introduction to Rochaix’s report, extracts of Vinatier’s report to de Gaulle, a letter from a representative of the general council, and more. The reader is referred to the book⁶ for more detailed references and documents. What follows herein is a summary of the story of Vinatier from the authors’ perspectives, published now in English, so that a shorter version can reach more readers.

Evil, Terrorism & Psychiatry

9781108467766

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Foreword

Pietro Pietrini

Medical Disclaimer

Table of Contents

Foreword

Preface

Stefano Salvatori and Donatella Marazziti

Bernhard Bogerts , Maria Schöne , and Stephanie Breitschuh

Claudio Bonito and Guido Traversa

Matteo Pacini and Icro Maremmani

Antonio Ventriglio and Dinesh Bhugra

Patrick Lemoine and Stephen M. Stahl

Donatella Marazziti , Antonello Veltri , and Armando Piccinni

Konstantin N. Loganovsky , Natalia A. Zdanevich , Marina V. Gresko , Donatella Marazziti , and Tatiana K. Loganovskaja

Armando Piccinni , Donatella Marazziti , and Antonello Veltri

Donato Marzano

Anne Maria Möller-Leimkühler

Dorte Sestoft

Alberto Carrara

Erich Vad

List of Contributors

Index

Index

Contributors

Introduction